Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Mark Allan Greenwalt, PA-C

Individual provider Medical Physician Assistant · NPI 1083435424

Mr. Mark Allan Greenwalt, PA-C is a Physician Assistant in Tacoma, Washington. Qualified in 2023, 3 years ago. Practices with Kaiser Foundation Health Plan of Washington, a 1,519-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
3
Licensed in
WA
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

9505 S Steele St
Tacoma, WA 98444-1858
Phone: (253) 597-6800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA61611340 (WA)

Record details

NPI number1083435424
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 18, 2024
Last updated in NPPESNovember 20, 2024
Certification dateNovember 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Kaiser Foundation Health Plan Of Washington — 1519 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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